Patient Access I Full Time

Wentworth-Douglass Hospital, an affiliate of Mass General Brigham, is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research.

Wentworth-Douglass Hospital remains among the nation's top hospitals for patient experience as a recipient of the Healthgrades 2021 Outstanding Patient Experience Award for the eighth consecutive year. Wentworth-Douglass Hospital is renowned as one of the largest acute care hospitals in the Seacoast region of New Hampshire and Southern Maine. At Wentworth-Douglass, we value people who contribute to patient-centered care that enhances community health; we recognize and reward those who share our values and transform our patients' lives. We invite you to explore opportunities, cultivate community wellness and professional growth.

The Patient Access representative will be responsible for the scheduling and registration functions for Wentworth Douglass Health Systems (WDHS). The individual specializes in providing exceptional customer service, creating new patient medical records, verifying insurance eligibility, collecting demographic information and offering applicable documents. The Patient Access representative must be able to hold in-depth financial conversations with patients in order to provide cost transparency and improve financial success of the organization.

The Patient Access representative is typically the first point of contact for patients entering WDHS and is responsible for managing both in and outbound calls as well as scheduling and registering patients for services utilizing enterprise-wide computer-based systems. All Patient Access staff will effectively communicate and collaborate with both internal and external customers in a team environment to ensure effective and accurate patient scheduling, registration, billing and ultimately the overall financial success of the organization. In addition, they will maintain a focus on customer service and patient confidentiality as well as Key Performance Indicators (KPI) to align with WDHS and Partners Revenue Cycle Patient Access Standards.

1. Utilizes organizational, clerical skills and computer applications to ensure an efficient functioning department and assist with the daily operations.

a. Becomes cross trained within Patient Access

b. Answers telephones, takes and relays messages in a timely and efficient manner.

c. Maintains work area in a professional manner.

d. Utilize internal & external resources to resolve issues.

e. Troubleshoots department equipment. Notifies department manager or supervisor or IS of unresolved failures.

f. Maintains filing systems according to department standards.

g. Efficiently utilizes and maintains the knowledge pertinent to the various computer applications and systems within the department.

h. Performs other duties as requested (ex. audits, reports, and/or special projects).

i. Able to multitask to ensure efficiency without compromising a high-level accuracy and professionalism.

j. Demonstrate a willingness to adapt in a variety of settings and perform other tasks as assigned.

2. Obtains all information to complete the Registration and Scheduling process accurately and efficiently.

a. Properly search for patients as to not create duplicate medical records.

b. Accurately update patient demographic and financial information.

c. Document pre-certification/authorizations, Nextgen number, and ORSOS case numbers into the system as needed.

d. Verifies Medical Necessity utilizing the current available applications on required services.

e. Completes insurance verification utilizing the current electronic verification system, online applications, or telephone to include the Medicare Questionnaire and informs the patient of any discrepancies.

f. Reviews orders for any discrepancies and screening requirements. Follows all protocols and procedures. Works in conjunction with the ordering physician as necessary.

g. Works in conjunction with Patients, Physician Practices, and Ancillary Departments to schedule services.

h. Properly enters referrals and/or orders into the appropriate application.

i. Offers Patient Rights information, Advanced Directives and other applicable handouts.

j. Understands and can explain Patient Registration Consent Form(s) to population served.

k. Activate accounts

l. Collect copayments and prepayments at the time of check-in when applicable and accurately post payments to patient accounts.

m. Demonstrates competency with the features and benefits of the patient gateway and able to enroll patients and respond to applicable patient gateway inquiries.

n. Consistently achieve an average 98% accuracy rate of registration for all scheduled services in accordance with Health Financial Management Association (HFMA) KPI standards.

o. ED Registration Area: Responds to emergencies within the Nurse First Expectations and alert the appropriate personnel.

p. ED Registration Area: Prepare death certificates upon notification from authorized personnel, secure and obtain signed release.

3. Provides exceptional customer service.

a. Interacts with all individuals in a consistent manner, providing attention, support and assistance to foster an environment of exceptional personal customer service.

b. Maintain a pleasant and helpful demeanor and present a professional appearance toward all internal and external customers at all times.

c. Communicate clearly and appropriately with patients while demonstrating respect, courtesy, and sensitivity. Complies with hospital and department Standards of Excellence with a focus on patient satisfaction

d. Greets, escorts and/or directs internal and external customers.

4. Acquires and maintains current knowledge and competency in Patient Access and the Revenue Cycle.

a. Participates in ongoing educational activities related to Patient Access.

b. Acquires new knowledge and skills appropriate to Patient Access.

c. Seeks constructive feedback regarding his or her own work in the patient revenue cycle. Makes changes based on feedback provided.

5. Demonstrates a high level of proficiency with the duties and responsibilities.

a. Plans and performs additional functions within the team assignments and department as directed.

b. Requires minimal direct supervision and functions well within the team and fosters the team initiatives.

c. Coordinate Care Van services if applicable.

d. Rehab Areas: Manages daily schedule for multiple therapists, including administering the waitlist.

e. Rehab Areas: Sets up and administers the FOTO program including discharges 10%.

Experience Minimum Required

* Minimum of 6 months experience working in a customer service setting, and/or clerical experience, or equivalent education.

Experience Preferred/Desired

* Previous experience in a healthcare setting.

* Preferably in a hospital setting

Education Minimum Required

* High School Diploma or equivalent experience minimum of 1 year working in a customer service setting

Special Skills Minimum Required

* The ability to multi-task in a fast paced environment.

* Present in a calm, professional manner.

* Requires the knowledge and ability to utilize various computer and on-line applications.

* Offer exemplary internal and external customer relations.

* Strong relationship building skills.

* The knowledge of medical terminology and insurance authorization.

* Good communication skills, both written and verbal.

* Have a general understanding of the impact Patient Access has on Revenue Cycle.

Wentworth-Douglass Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.